Consequences of Falls in Nursing Homes
Barry: Well, there are really two common kinds of injuries you see. One of these is braid bleed, somebody falls and hits their head, and especially when you have a patient who's on blood thinners, these are often fatal injuries. These are injuries that are really just not operable.
The other kind of injury that you see most frequently are fractures, and the most common kind of fracture you see is a hip fracture, and these are actually really grim injuries for people who are in a nursing home setting, for people who are senior citizens.
Pam: So do fall cases frequently end up being wrongful death cases?
Barry: They do. You have to keep in mind that in a wrongful death case, it's our burden to show that the fall was a cause of the person's death, not the cause, not the major cause, not the most important cause, but a cause, so when I look at these kinds of cases, I really sort them into three baskets, if you will. One basket would be where the death was immediate and the death was really very clearly caused by the fall. I handled a case a few years back where a gentleman was admitted to a nursing home. The staff promised the daughter that they would use a bed alarm. They couldn't find a working bed alarm in the nursing home to use on him. He got up early the next morning to go to the bathroom without any help. He fell, he hit his head on the floor, he developed a brain bleed, and ended up passing away about 12 hours later. That's a case where the death was very clearly a result of the fall.
The second basket of cases I look at are ones where the death occurred in the immediate postoperative period. Typically, after a surgery, you'll see like a heart attack, or a stroke, or some signature event that's really associated with the operation or the injury itself. Those are cases where you need to have a good handle on the medicine, but it's still a situation where it's relatively easy to establish that the death was a result of the fall occurring. A lot of times, these will be disputed cases, especially where the death involves a cardiac issue, because a lot of times, when you get up into your 70s, 80s, and 90s, you have these underlying cardiac problems, and the defense line will always be that they died with a broken hip, not because of the broken hip.
The third basket of cases that you really look at are cases where the death is further removed from the fall itself, but is really a result of kind of a downward spiral that starts with the fracture having occurred. So, if somebody were to fall, break a hip, and not have any progress with rehab, not be up and walking, and start to develop pneumonia, and weakness, and that kind of thing, those are situations where it's more difficult to tie the death to the fall. It's certainly not impossible, and if you have a good handle on the medicine, if you have a good understanding of the documentation that's available, a lot of times, it's something that you can establish relatively easily, but it takes a bit more digging to try to do that.
Under any of these set of circumstances, falls often result in what become wrongful death cases, unfortunately.